Treatment of tic douloureux (trifacial or trigeminal neuralgia) in Germany

Trigeminal neuralgia is a condition that is characterized by the recurrent short episodes of intense pain in the innervation area of one or more branches of the trigeminal nerve. This chronic disease usually affects people over the age of 50. It is more common in women than in men. The overall incidence is about 3-4 cases per 100.000 of population per year.


The Booking Health portal presents 52 German clinics specializing in tic douloureux (trifacial or trigeminal neuralgia) treatment

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Trigeminal neuralgia – Diagnostics

Trigeminal neuralgia is diagnosed on the basis of the clinical manifestations of the disease. A diagnosis is confirmed in presence of four out of five criteria determined by the International Headache Society:

  • Pain is located in the trigeminal nerve branches innervation areas.
  • In one patient pain episodes are always identical.
  • Pain is sudden, sharp, like an electric shock. It is caused by mechanical irritation of the face, chewing, or contraction of facial muscles.
  • Pain decreases after the carbamazepine intake.
  • Absence of a pain in the interictal period.

Instrumental methods help in diagnostics. They are necessary for revealing causes of the pathology. These techniques are:

  • MRI (magnetic resonance imaging) allows to detect the brain tumours, multiple sclerosis and other neurological diseases. An MRI scan is able to detect the proximity of the blood vessel to the branches of the trigeminal nerve, which is revealed in approximately 85% of patients.
  • CT (computed tomography) is a less expensive as well as less informative alternative to MRI.
  • Electroneurogram determines the speed of impulses along nerves. It allows to reveal demyelination of the trigeminal nerve (the degradation of the myelin sheath in the place of contact with the blood vessel).

If the symptomatic trigeminal neuralgia is suspected, a number of other laboratory and instrumental examinations can be performed and the choice depends on the basic disease.


Best clinics for the trigeminal neuralgia diagnostics in Germany:


University Hospital Bergmannsheil Bochum

University Hospital Bergmannsheil Bochum


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University Hospital Duesseldorf

University Hospital Duesseldorf


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Trigeminal neuralgia – Treatment

In case of secondary (symptomatic) trigeminal neuralgia therapy of the basic disease is required. Treatment of primary trigeminal neuralgia requires conservative or surgical methods.

  • Drug therapy is used to treat the majority of patients. Antiepileptic medicines are prescribed. When the main therapeutic effect is reached, the dose is reduced up to the supportive one and the patient takes it life-long. Eventually, an addiction may develop and the dose might be increased again. If a person refuses the treatment, the pain occurs again with time.
  • Physiotherapy and reflexotherapy are additional methods that provide only a temporary and poorly expressed effect. 
  • Intraosseous blockades are used in case of the ineffectiveness of drug therapy. Anaesthetics are injected into the skull bone. Several of these procedures can reduce the severity of pain in some patients for a period from 1 to 6 months.
  • Microvascular decompression is a neurosurgical intervention. It is performed in the case of the primary (idiopathic) neuralgia. The essence of the surgery is to relieve the abnormal compression of the branches of the trigeminal nerve and the adjacent blood vessel. Basically it is the front or posterior inferior cerebellar artery, basilar or vertebral one. A protector is set between vessels and nerves. The operation causes the throbbing artery to cease irritating the nerve and neuralgia symptoms disappear.


Best clinics for the trigeminal neuralgia treatment in Germany:


Bundeswehr Academic Hospital Berlin

Bundeswehr Academic Hospital Berlin

Diagnosis and conservative treatment of trigeminal neuralgia


Treatment of trigeminal neuralgia by microvascular decompression of trigeminal nerve root


University Hospital of Ludwig Maximilian University of Munich

University Hospital of Ludwig Maximilian University of Munich

Diagnosis and conservative treatment of trigeminal neuralgia


Treatment of trigeminal neuralgia by microvascular decompression of trigeminal nerve root


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Trigeminal neuralgia– Rehabilitation

The most modern rehabilitation programs are used in Germany. They are adapted individually for each patient, and are based on the disease stage, age, physical possibilities, and the results of treatment. Different specialists such as: therapists, neurologists, psychologists, rehabilitators, kinesiotherapists, physiotherapists are involved in the rehabilitation process.

The following methods of rehabilitation are used:

  • Dosed physical activity
  • Training on the simulators and in the pool
  • Individual orthoses
  • Physiotherapy
  • Acupuncture
  • Manual therapy
  • Transcranial magnetic stimulation
  • Natural factors of the nature (mud, thermal waters, etc.)
  • Individual or group therapy with a psychologist

Rehabilitation may include medicamentous support. It is necessary to hold a consultation with the patient about the proper nutrition and the way of life which is important for him in the current situation.

Rehabilitation programs in Germany are designed for 2 weeks. If necessary, they can last much longer. In this country, the patient is provided with qualitative care, accommodation in comfortable rooms and individually selected meals.

Rehabilitation programs in Germany show one of the best results in the world. Most patients successfully restore their working capacity and excellent health there. They remain physically active, return to the full social and family life.


Best clinics for neurological rehabilitation in Germany:


Neurological Rehabilitation Clinic Godeshöhe Bonn

Neurological Rehabilitation Clinic Godeshöhe Bonn

1093help813Per day

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Author: Dr. Nadezhda Ivanisova

Here you can find the cost of treatment for this disease at the German University Hospitals. Leave a request and we will provide a free consultation with a doctor and will start organizing the whole treatment process.

The program includes the following:

  • Issuing of an invitation for getting a visa for treatment as quick as possible
  • Fixing an appointment at a time convenient for you
  • Preliminary organization of a comprehensive examination and discussion of the forthcoming treatment plan
  • Arranging transfer from the airport to the hospital and back to the airport
  • Provision of interpreting services and services of a personal medical coordinator
  • If necessary, assistance in the organization of further surgical treatment
  • Provision of a medical insurance against treatment complications covering up to 200,000 euro
  • Preparation and translation of medical records and recommendations from the hospital
  • Assistance in the subsequent communication with your attending physician, including consultations on repeated X-ray images through the unique medical document management system E-doc

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